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My previous neuro formerly ran the Swedish Pain and Headache Clinic in Seattle....now at Stanford University Med Center....and a well regarded researcher. Best neuro I've ever met...or at least tied with the guy who did my brain surgery last year. She advised to steer WAY clear of Naproxen for anything more than occasional use (perhaps shadows?) as it has far more negative side effect potential than benefits...she called it a "nasty med"...
Re the verapamil...she was quite the fan....and depending on point of cycle I was using 960-1040 mg/dy (immediate release...not extended). Doses beneficially timed prior to usual hit times. Many reports of 480 mg/dy being the sweet spot for clusterheads (that's what I used in low cycle). 360 sounds low but your particular situation depends on many factors. Discuss with your Doc maybe upping the dose. O2 not working? How about the D3?

This is just delightful news....seems I've been waiting 30+ yrs to hear something like this!!!
Sorry if I missed this.....any idea when available? Any idea of cost? What is expected of the insurance companies re coverage?
Anecdotal...I was treated with another monoclonal antibody (Rituximab) for a completely different condition. It's been 2+ yrs now... and while I still get the occasional hit...and frequent shadows....it is completely different (and LESSER) than the previous years experiences (which may be equally anecdotally tied to 'aging out of CH"...which I relied on in times of desperation.) Just seemed remarkably "coincidental"....
Best
Jon
Edit to add: I ask about cost because the Rituximab cost over $10,000 per infusion....18 times.

Hey BCJ...sorry to see this given to a CH patient without qualification for THAT condition. NOT uncommon for O2 suppliers to be ignorant of clusterhead needs(btw...DIFFERENT than venal or uncaring, since 'ignorant" is fixable). I have been a Lincare patient since 1985 (tho not lately) and found the most important part of the relationship was with the store manager. Some are perfect for the position (care, concern, compassion, flexibility)...some are just droids. I suspect Lincare corporate has tightened down on options available to individual managers...and I suspect it's a) corporate paranoia (read that lawyers got involved...SHEESH, that always come out well) and b.) the increasingly complex, confusing, and voluminous requirements that health insurance companies have visited on EVERY aspect of the health care "industry". I've had several doctors quit because of it..... and some other types of providers decline patients with particularly troublesome insurance.
So....your first step should be developing a relationship with the manager (give 'em a copy of this: http://www.clusterheadaches.com/O2/index.html)...can't hurt....second would be to get a script with HIGHER lpm listed....AND the medical necessity letter you described (this can be PRICELESS in MANY circumstances beyond just O2). My script said 8 lpm...I used 5-15 without any concern over being monitored for usage. Actually, I talked them into stocking M tanks...since E tanks are much smaller and lasted only a few hits for me. Kept 2 M's for home...and 3-4 E's for 'travel' and work (one in car, one at work, two in reserve.) Regulators off the internet...don't buy or...God forbid... lease them from the supplier. I got 2 25 lpm name brand regs for $25 ea!! And a non rebreather mask from CH.com store (a PRIZED possession).
Lot of folks out there go with welding O2...NONE of the problems described above....probably cheaper...just less convenient depending on your health level and living situation (e.g. 3rd floor apt....no elevator...YIKES!). Still, If you travel out of state...Lincare has an excellent program for continuance of service in many far flung locations. I used it in Oklahoma, Nevada and California multiple times. Kinda tough to drag a welding tank around.......................
Best
Jon
PS Sorry for any redundancy...I failed to re read the whole thread.............................

Hi big j...I am hoping you will hear from someone with WAY more knowledge on Vit D than I EVER will have...
...meanwhile...trust your instincts...clusterheads tend to have a much more refined "feeling" about their body and its functions than most others...
...different forms of the exact same med or supplement can have TOTALLY different efficacy.....perhaps due to differing blood serum levels...or how/how much absorbed..
...different forms are absorbed differently by the body...some directly to bloodstream (like sub-lingual or IV)... some through stomach or small or large intestine....some directly affected by the surrounding ingestions (e.g oil soluble vitamins are absorbed better when accompanied by oil containing foods)
.....seniors and alcohol abusers tend to have deficient levels of B12 (my belief this deficiency rivals the near universal VitD deficiency)....it may not be absorbed well by the gut...sublingual/injectable frequently work betta than tablets....
....in my case...extended release verapamil was totally worthless.... while immediate release proved about 70% effective
...this is a large subject...alas...I can only touch the surface....
Best
Jon
PS....to add...NEVER crush or chew a med or supplement without specific instruction from a knowledgeable professional...it changes intended absorption characteristics...as described above
...

EXCELLENT post Craig.....I JUMPED up at that last sentence too! EXACTLY.....life's a journey...an interesting one.....CH is just another car in the train.................and they're all connected..................

Welcome Dima....glad you found us...some good folks will be by shortly to reply...in the meantime..
It's strange.....for some...like myself...stress is protective...relief FROM stress is a trigger......

Anecdotal: I've had multiple autoimmune disorders...CH was the first....MS was suspected by several neuros....lymphoma and numerous environmental/food allergies followed. Antihistamines were helpful during my early ch career. I can't prove or attest to a damn provable thing...sometimes ya just "know"...I await the studies to affirm......
Best
Jon

I would just like to add...to the always pertinent, consistent, and delightful support from CHf. O2 should be the first resort provided to ANY clusterhead...from ANY physician....and I don't care what their "training". The literature is OVERWHELMED by the evidence for its efficacy!!! Myself....I would estimate over 5000 hits aborted by OXYGEN (that may be a low estimate). My sanity...maybe my LIFE....owed to a few green headed tanks..... a proper non-rebreather mask...well defined technique....and folks like you will find here and at ch.com.......................................
Best
Jon

I got mixed feelings on "stopping" what seems to be working. Batch...our resident jet jockey does this on occasion...and I can't explain why...spits and giggles?...dunno...maybe he'll share......
While it is always interesting to evaluate whether...through trial and error...something seems to work....there are clusterheads in ditches all over the world who found something that worked...then it STOPPED WORKING...with no rhyme or reason....I'm much too much a wussie to challenge the beast to "bring it on!"....

Shadows are weird...at one point a shadow...for me...was just the prelim for a hit. But as, spiny says...they don't always presage one. Mostly now, it's what I live with....sometimes all day (can I say a fella can get used to them (considering the alternative) without pissing you good folks off?) Fortunately...you will eventually learn the difference...which I really can't explain.....you just know this aint gonna progress. Odd in other ways, shadows are really hard to "kill" for me....very resistant to O2, energy drinks...and I don't waste a Zomig on one anymore...gotta save them pricey/insurance restricted bullets..........and usually a single point of pain rather than the trigeminal pathway.....
BTW...guess I haven't been paying attn...don't recall hearing about ginger ...and I eat crystallized ginger and drink ginger beer regularly. Probably cuz I'm just too dumb to recognize "hey that worked!"...............
Best
Jon

Similar here....had a great neuro...now at Stanford. We did a methylprednisolone (described by her as souped up prednisone) IV and then taper. Completely stopped the cycle (was ECH at the time) without need for verapamil. Damned miraculous I thought...but think again jonboy. The next two times same protocol had NO effect and I refused any further attempts out of 'pred fear". DID do the verapamil for many yrs...sometimes going over 1000 mg/dy....lucky to not have any consequential side effects and it was 70% effective in stopping or lessening hits....with O2 taking care of the rest and Zomig nasal spray (5 mg) for the occasional breakthrough......